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What is chemo brain?

Page last modified on: December 3, 2008
Question from MC: What is chemo brain?
Answers —Christina Meyers, Ph.D., A.B.P.P.: It's basically inefficiency of certain cognitive functions, related to cancer or cancer treatment. It is characterized by inefficient memory retrieval, so people block on people's names or numbers, but they always come back. There’s a reduction in how much information a person can handle at once, so if I give someone a 12-word list to learn, a person with this syndrome will only get 8 or so. It's almost like an attention deficit; people are slower to do things and it takes more mental effort to do everything. Reasoning, problem solving, talent — those aren't affected.
George Sledge, M.D.: What disturbs me when I hear this is that you're describing me! A challenge to physicians dealing with patients is the lack of something objective to the diagnosis, which is true of many things in psychology and psychiatry. If I'm a patient or physician, can you give me DSM [Diagnostic & Statistical Manual for Mental Disorders] criteria or some specific criteria that determine who has chemo brain and who doesn't?
Christina Meyers, Ph.D., A.B.P.P.: It's a differential diagnosis. Neuropsychological tests are very objective and what we're measuring are subtle declines compared to a person's pre-illness level of function. So I may see a person who complains of these symptoms, but chemo brain is a diagnosis of exclusion, which means a person may subjectively feel their memory isn't as good, but it may be they have cancer-related fatigue so they're too tired to think well or they're preoccupied and can't pay attention to what people are saying. It could certainly be an unrelated condition that has nothing to do with the cancer treatment. We do standardized tests where we know how a person of a given age and education would normally do on these tests, so that's how we test to see if they are having any difficulty. There are no DSM criteria at all, but most insurance carriers do recognize the syndrome and consider it a reason for disability, so it's in there.

On Wednesday, October 15, 2008, our Ask-the-Expert Online Conference was called Managing Chemo Brain. Christina Meyers, Ph.D., A.B.P.P. and George Sledge, M.D. answered your questions about how long chemo brain can last, what treatments can be helpful, and current research on cognitive effects of breast cancer treatment.

The materials presented in these conferences do not necessarily reflect the views of breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.

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Meet the Experts

Christina Meyers, Ph.D., A.B.P.P. is a board certified neuropsychologist. She created the Neuropsychology Service in the newly formed Department of Neuro-Oncology at M.D. Anderson Cancer Center in 1984.

George Sledge, M.D.George Sledge, M.D. is the Ballvé-Lantero Professor of Oncology at Indiana University at Indianapolis, where he co-directs Indiana University Simon Cancer Center's Breast Cancer Program.

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